If cancer doesn’t kill you, chemo might—or at least, some days it feels that way. It’s a treatment designed to kill cancer cells, but it takes plenty of innocent bystanders—your healthy cells—down with it. And then there’s Doxorubicin, nicknamed the Red Devil for a reason. This drug has a reputation, a lifetime limit, and a warning label that reads like a horror story. I’ve now met the infamous Red Devil, and let me tell you, it lives up to its name.
When I used to think about cancer, I pictured someone frail, bedridden, with dark circles under their eyes. I thought cancer was the culprit, but chemo—the very thing meant to save us—often strips away vitality in the process. During the first 12 weeks of my treatment, I found a rhythm: Fridays were infusion days. The next 24-72 hours brought fatigue and fogginess (hello, falling asleep mid-sentence and misplaced groceries). By Tuesday, I’d feel more like myself. It wasn’t easy, but it was predictable, manageable even.
Then came phase two. And the Red Devil.
Meet the Red Devil
Doxorubicin doesn’t just attack cancer; it’s an equal-opportunity destroyer, and its side effects pull no punches. Its bright red hue stains your pee and feels like it’s swinging at every organ in your body, leaving you wrestling with a laundry list of side effects. It’s especially rough on the heart and bone marrow, so baseline tests are a must before treatment to gauge whether you can take the hit—and it requires lifetime monitoring for heart failure. Every infusion feels like a gamble—how much can my body handle? How much damage is too much?
Here’s a surprising science detour: The Red Devil has roots in soil microbiology. Discovered in the 1960s by Italian researchers, Doxorubicin is a bacteria strain found in soil capable of producing cancer-fighting pigments. Marketed as Adriamycin—after the Adriatic Sea—it’s an undeniable force against cancer, disrupting cell DNA to stop growth. But its indiscriminate attack on healthy fast-dividing cells, like those in your hair and stomach lining, makes its side effects legendary.
I’m one infusion into this phase and staring down the barrel of the second. Within hours, it feels like I’ve been hit by a freight train. Flu-like symptoms flood in—chills, hot flashes, dizziness, extreme fatigue, and relentless nausea, all at once. By the next day, I can barely move. My muscles ache, my bones feel brittle, my eyesight blurs, I have shortness of breath and chest pains, and my ears ring incessantly. Emotionally, I’m a pendulum, swinging wildly between extremes (early menopause), while my thoughts scatter like a broken puzzle (chemo brain).
By day six or seven, the fog starts to lift, and I begin to feel human again—or at least some version of myself. But the fatigue still clings like a shadow, my dry skin stubbornly cracks, my eyebrows and lashes begin falling out, and the burning sensation when I pee reminds me this fight isn’t over. Even simple tasks—typing, buttoning, zipping—become exercises in frustration, as my fine motor skills falter. And before taking any medication, I play side effect roulette: Do I want to take a chance that this medicine designed to stop the nausea will give me a rash, or, the one that will give me a migraine? This isn’t just a physical fight; it’s a mental and emotional battle, too.
The Struggle with Rest
Rest doesn’t come naturally to me. I’ve always been a planner, a doer, someone who thrives on squeezing the most out of life. Slowing down feels counterintuitive, like letting life’s moments slip through my fingers. Yet, chemo doesn’t allow for that kind of energy. It’s forced me to confront an uncomfortable truth: sometimes, the most productive thing I can do is…nothing.
I’m working on reframing my belief that rest isn’t indulgent—it’s essential. It’s the medicine my mind and body need to recover and the fuel that allows me to show up for my family, my work, and myself. But granting myself permission to rest feels like a Herculean effort. I tell myself I’ll stop only when everyone around me is cared for, and every loose end is tied up. But let’s be honest—when does everything ever feel “done”?
This sense of undone tasks often feels like a personal setback. I’ve always been someone who finds purpose in doing, planning, and caring for others. Watching others step in to help while I sit on the sidelines feels deeply unsettling. Helplessness creeps in, a quiet but relentless voice reminding me I should be the one doing. Instead of resting, I often find myself hunting for new tasks or distractions, as if proving I’m still useful.
Still, I know rest is critical—not just for my body but for my spirit. When I manage to quiet the world, silence my inner critic, and let myself rest, I can feel its value. It renews me. It matters. But getting to that place is a daily lesson in letting go, trusting those around me, and believing that rest isn’t indulgent—it’s a part of healing.
When Showing Up Feels Like Falling Short
Another difficult part of this phase is reconciling this with my roles as a mom and a professional. I’ve had to lean on my family for help with parenting—relying on others to step in for daily activities I would usually cherish, like driving to practices or putting my kids to bed. The emotional weight of not always being the mom I strive to be—playful, active, and fully engaged—can be heavy. Similarly, at work, I’ve had to reset expectations, extending timelines on initiatives or delegating tasks I would typically take pride in managing.
Even with these adjustments, the feeling of “not enough” and the guilt of relying on others persist—a constant reminder of my current limitations. Balancing these two worlds has forced me to redefine what showing up looks like, whether it’s finding quiet but meaningful ways to connect with my kids or being honest with my colleagues about the potential moments of forgetfulness. It’s a dual challenge that continues to reshape my sense of identity and while I haven’t found the answers, I’m learning to keep moving forward in the messiness of it all.
Despite the physical toll, bad days often carry an even heavier mental load. Calling on others to step in—whether to manage daily parenting tasks or to pick up slack at work—leaves me grappling with the guilt of not being enough. It’s a stark reminder of my limitations and the constant juggling act of this phase.
Finding Myself in the Eye of the Storm
About 12 days into the 21-day chemo cycle, I start to feel like myself again—not just the pre-Red Devil version, but glimpses of my pre-chemo self. My spirits lift, and for the first time in weeks, I find myself smiling with ease, sleeping through the night (no insomnia!), and embracing a rare sense of calm amidst the chaos. My energy levels creep back, and my mental clarity returns, though I’m still really tired and crash before the kids at night.
Even more surprising, my sex drive pulls a Lazarus and makes a dramatic reappearance—apparently, even chemo can’t kill the mood entirely! I even made homemade chocolate chip cookies—an accomplishment that feels almost celebratory. My hunger roars back, and I can’t tell if it’s because my metabolism is working again or because my mouth sores have finally subsided, allowing me to truly taste food. Either way, I lean in, indulging in tacos and chocolate chip cookies for days. No regrets!
A friend recently asked me if it’s better or worse to feel so good before diving into another round of chemo. My answer is simple: it’s good. It gives me hope to recognize myself again, to feel that I’m still here beneath it all. These moments of clarity and energy become my anchor. When the next cycle’s aches, pains, and swirling bad thoughts take over, I hold tight to the memory of these good days, knowing they’ll come again.
Fighting Forward
Despite everything, I’m grateful. I’m grateful for the science that makes this fight possible, for the support system that holds me up—especially Andy and my parents, running the household when I can’t muster the strength: the fridge is stocked, the dog is walked, holiday and birthday magic gets delivered, the kids’ “buckets” are full, and the list goes on and on. I’m grateful for the milestones that remind me why I’m enduring this, even on the hardest days.
As tough as the Red Devil is, it’s a tool in this fight—a brutal, unforgiving one, but a tool nonetheless. And each day I claw through it brings me one step closer to the other side.
To anyone facing Doxorubicin, I won’t sugarcoat it—it’s hard. There’s a reason oncologists delay sharing the gritty details. But here’s the truth: you’re harder. There’s no other choice.
For those following along and wondering what the path looks like, here’s a breakdown of the treatment timeline:
